Common causes behind involuntary mouth movements
Repetitive or involuntary mouth movements, such as lip smacking, chewing, or tongue protrusion, are a common observation among older adults. While they can sometimes be harmless, they often signal an underlying health issue that requires attention. Understanding the potential causes is the first step toward effective management and better quality of life.
Oral health and dental issues
One of the most frequent reasons for repetitive mouth motions in seniors is discomfort or issues within the mouth itself. As people age, several dental factors can contribute to these movements:
- Dry Mouth (Xerostomia): Reduced saliva production is a common side effect of many medications prescribed to seniors, and can also be caused by dehydration. To combat the discomfort and attempt to stimulate saliva, an individual may unconsciously chew or move their mouth.
- Ill-Fitting Dentures: Dentures that are loose or uncomfortable can prompt the wearer to constantly adjust them with their tongue and jaw, leading to repetitive movements. Proper dental care and regular check-ups are essential to ensure dentures fit correctly.
- Missing or Worn Teeth: The loss of natural teeth changes the way the mouth and jaw function. When teeth are missing, the jaw's natural "stopping points" are gone, which can lead to it moving around in a search for equilibrium. The wearing down of teeth over time can have a similar effect.
Neurological conditions
Many involuntary mouth movements are a symptom of neurological disorders, which are more prevalent in older age. The brain's control over muscle movement can be affected by these conditions.
- Tardive Dyskinesia (TD): This is a movement disorder characterized by uncontrolled, repetitive body movements, most often affecting the face, lips, tongue, and jaw. TD is typically a side effect of long-term use of certain medications, particularly antipsychotics used for conditions like schizophrenia, bipolar disorder, and severe depression. The risk of developing TD is higher in older adults.
- Parkinson's Disease (PD): While tremors in the limbs are the most recognized symptom of PD, involuntary movements can also affect the jaw and lips. These tremors often occur at rest and can cause the jaw to tremble or the teeth to click. In some cases, PD medications like levodopa can also induce mouth movements as a side effect.
- Dementia and Alzheimer's Disease: Cognitive decline can lead to repetitive behaviors known as perseveration, which can manifest as constant chewing or other repetitive mouth movements. The brain's ability to control and inhibit specific actions can be impaired, resulting in these unintentional gestures.
- Stroke: Damage to certain areas of the brain from a stroke can result in motor control problems in the orofacial region. This can lead to difficulties with swallowing, a facial droop, and other movements related to muscle weakness or dysfunction.
Medications and other medical factors
Beyond specific neurological disorders, a wide range of common medications and other health conditions can trigger oral movements in seniors.
- Medication Side Effects: In addition to antipsychotics that cause tardive dyskinesia, several other types of drugs can cause similar symptoms, including some antidepressants, mood stabilizers, and anti-nausea medications.
- Stress and Anxiety: High stress levels can lead to habits like teeth grinding (bruxism) or jaw clenching, both of which involve repetitive mouth activity. In older adults, stress and anxiety are often underdiagnosed and can manifest physically.
Addressing the issue: What caregivers and families can do
If you observe repetitive mouth movements in a senior, it is important to first approach the situation with patience and empathy. Avoid drawing attention to the behavior in a way that causes embarrassment. The most critical step is to consult a healthcare professional to identify the underlying cause. A doctor can review the person's medications, check for neurological conditions, and recommend a dental consultation.
| Condition/Cause | Key Characteristics | Management Approaches |
|---|---|---|
| Tardive Dyskinesia | Involuntary, repetitive movements of the face, jaw, lips, and tongue; often linked to long-term antipsychotic use. | Medication review by a doctor, dose adjustment, or switching to a newer drug with lower risk. FDA-approved treatments are available. |
| Oral Health Issues | Chewing, smacking, or adjusting of the mouth due to dry mouth, pain, or ill-fitting dentures. | Regular dental check-ups, ensuring dentures fit properly, using saliva substitutes, drinking water, or chewing sugar-free gum to relieve dry mouth. |
| Parkinson's Disease | Jaw or lip tremor that is often present at rest and can be intermittent. | Medical evaluation and treatment with Parkinson's medications; deep brain stimulation may be an option for severe tremors. |
| Dementia-Related Behavior | Repetitive chewing or other oral motions as a form of perseveration, especially common in more advanced stages. | Managing with a calm, patient approach. Use verbal cues or gentle reminders. A soft, moist diet can also help with eating. |
| Side Effect of Other Meds | Oral movements linked to starting or increasing the dose of certain antidepressants, anti-nausea, or other drugs. | Discuss symptoms with a doctor who can adjust medication, if necessary. Never stop medication abruptly without consulting a physician. |
| Stroke | Oral weakness or facial drooping that affects lip closure and chewing, possibly leading to pooling saliva. | Speech and language therapy, physical therapy, and other rehabilitative treatments to regain oral motor control. |
Living with involuntary movements
For both the individual and their caregivers, understanding the source of involuntary mouth movements is key to managing the condition and reducing anxiety. A definitive diagnosis is the first and most important step. If the cause is a medication side effect, a doctor may be able to adjust the dosage or switch the medication to one with a lower risk profile. For those with neurological conditions, treatment focuses on managing symptoms and improving quality of life. Regular communication with the care team—including doctors, dentists, and specialists—is essential. Support groups can also provide valuable emotional support and practical advice for navigating the challenges of living with a movement disorder. For authoritative guidance on movement disorders, the American Parkinson Disease Association website is a valuable resource.
Conclusion
While repetitive mouth movements in older adults can be a source of concern and social discomfort, they are not an inevitable part of aging. From manageable issues like dry mouth and ill-fitting dentures to complex neurological conditions such as tardive dyskinesia and Parkinson's disease, a range of factors may be responsible. By seeking a proper diagnosis and understanding the underlying cause, individuals and their caregivers can find effective strategies for management. This proactive approach not only addresses the physical symptoms but also helps to reduce the psychological stress and social stigma that can accompany involuntary movements.
